| NPI | 1063827434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD500001758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD206234) |
| 207P00000X Emergency Medicine (Licence: VA 0101268264) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: VA 0101268284) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2023-10-11 |